MEDICARE: MS. DINA DURAN BLUME LPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor	20262	TX

General Provider Information

NPI Number	:	1063609923
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. DINA DURAN BLUME LPC

Provider Business Mailing Address
First Line	:	13114 BOHEME DR
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77079-7206
Country	:	US
Telephone Number	:	713-467-1947
Fax Number	:	713-467-5556

Provider Business Practice Location Address
First Line	:	11211 KATY FWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77079-2126
Country	:	US
Telephone Number	:	713-365-0700
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/25/2007
Last Update Date	:	09/25/2007

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